Family planning 101

Article Date

03 July 2013

Media Contact

Anne McPherson

Vice President, Global Communications email [email protected]

Uttar Pradesh, India – Shrimati is two years behind in her studies, a reflection of her circumstances, not her capacity to learn. On the contrary, it was immediately obvious that the 11th grader is a diligent pupil. When I asked Shrimati to tell me what sort of information she had picked up during a series of workshops on sexual and reproductive health and family planning, she held my gaze and answered in one long breath, only pausing when a swarm of nosey neighbors buzzed closer to eavesdrop.

“I learned about how I can take care of myself during pregnancy. I should get monthly check-ups, go to the hospital for delivery and I learned about good nutrition,” Shrimati said as the village men and women of Mustafabad drifted back, hovering just beyond the concrete ‘verandah’ where we were speaking. Shooed away once again, the uninvited guests dispersed and Shrimati continued.

“I also learned that after marriage if you use condoms you will be able to delay childbirth and I learned about other kinds of contraception too. When a boy and girl get married they have sexual intercourse and the woman can get pregnant which lasts for nine months. I was surprised because I never knew any of this before.”

This is not a place accustomed to talking about condoms and family planning. Shrimati, who is 18 years old, would have never learned such valuable life lessons in an ordinary classroom. Such subjects are not included in school curriculum in socially conservative rural India.

Shrimati is one of roughly 18,000 adolescent girls in India benefitting from an innovative program funded by the European Union and managed by the Delhi-based MAMTA Health Institute for Mother and Child in Uttar Pradesh and Bihar states. The project’s main objective is to prevent child marriage – an all too common practice in rural India which can lead to maternal mortality and complications for the child bride. As part of the project, girls are learning that waiting to begin a family will improve their wellbeing and that of their future families for years to come.

“I have decided I will not get pregnant until three years after I’m married. I will try to convince my husband of this, and if I can’t convince him, I will still not have children for three years. I will try to make him use a condom but if he refuses, I’ll just leave and come back to my mother’s house to live,” Shrimati said.

Another girl I met the following day, in a nearby village, parroted the same three-year plan. MAMTA’s local partner organization running the project in this part of Uttar Pradesh, ‘Award,’ has clearly done a remarkable job of changing age-old mind sets.<

An alarming 40 percent of the world’s child marriages take place in India. And in rural areas of the country some 56 percent of girls are still married before their 18th birthdays according to a recent report from the International Center for Research on Women (ICRW). Traditionally, girls from this part of rural Uttar Pradesh also married well before their 18th birthday, having children soon after and rarely making it past the seventh or eighth grade, if they were educated at all. Shrimati’s own mother never attended school and thinks that she married when she was 12 or 13. Although girls today tend to study longer and get married later, the practice persists.

ICRW, which is helping evaluate the project’s effectiveness in providing ‘youth friendly’ health services to adolescents, is placing renewed emphasis on the importance of working with girls at this vulnerable age. Launched in 2012, ICRW’s Turning Point Campaign is focusing resources on research and programs that address the unique challenges adolescent girls face to leading healthy, productive lives as adults. Ultimately, the campaign aims to change the course for adolescent girls worldwide.

In Uttar Pradesh, Award’s introduction of new ideas has occasionally caused some initial friction, rubbing up against age-old traditions and deeply-held beliefs about family, gender roles and marriage. Nonetheless, the health and economic benefits of delaying marriage seem to be resonating. One family I met had postponed their daughter’s wedding as a result of the intervention.

The project’s greatest asset may be its facilitators – young, local outreach workers recruited by Award with whom the villagers can identify. One such outreach worker called Pooja has made an indelible impact on Shrimati’s life by convincing her parents to let their daughter return to the local secondary school in Mallawan, a one-hour bicycle ride away from Mustafabad. The move will effectively delay marriage for Shrimati until she graduates.

“My father said, ‘I’ll eat half the amount of bread and spend the other half on education’,” she explained. “I can marry when I want if I’m educated and if I get married at a good age then my children will be better off because I can better take care of them.”

As the conversation came to a close, Shrimati’s mother Kamla led her visitors into a closed courtyard in the back of the house where she wanted her picture taken away from the neighbors’ prying eyes. It was there that I was introduced to someone new, someone who seemed to be hiding in the shadows. Her name was Minoo, a veiled girl with bashful eyes and a fresh bindi on her forehead, indicating she was married. She was Kamla’s 17-year-old daughter-in-law – a child bride. 

The contrast between the two girls living under the same roof was an abrupt reminder that universal transformation takes time, often sputtering along for years before the process is complete. But groups like MAMTA and Award are helping to ensure that all girls have equal chances in future generations. The chance to finish high school, to grow up to be healthy, productive women, and – if they so choose – to convince their husbands to use a condom.

A version of this story originally appeared in the Huffington Post.